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Survival of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC) versus Adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) at a single institution
  • +5
  • Sebastian de Armas,
  • Carolina Huertas-Ayala,
  • Randall Chan,
  • Yueh-Yun Chi,
  • Winston Huh,
  • Amanda Termuhlen,
  • Paul Gaynon,
  • Andrew Doan
Sebastian de Armas
Loma Linda University School of Medicine

Corresponding Author:sebastiandearmas@gmail.com

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Carolina Huertas-Ayala
San Juan Bautista School of Medicine
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Randall Chan
Keck School of Medicine of the University of Southern California
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Yueh-Yun Chi
USC Keck School of Medicine
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Winston Huh
Children's Hospital Los Angeles Department of Pediatrics
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Amanda Termuhlen
University of Minnesota System
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Paul Gaynon
University of Southern California
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Andrew Doan
Children's Hospital of Los Angeles
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Abstract

Background: ABVD, the standard-of-care in adult Hodgkin lymphoma (HL), has not been directly compared to ABVE-PC, a pediatric regimen designed to reduce late-effects. We aimed to compare the effectiveness and associated toxicities of these two regimens used in the same institution. Methods: This retrospective cohort study evaluated a total of 224 patients diagnosed with HL between 1999 and 2018 at Children’s Hospital Los Angeles (CHLA), of which 93 patients were eligible having received ABVD (n=46) or ABVE-PC (n=47) chemotherapy as their initial treatment. Descriptive analyses were performed using the Student’s t-test or Fisher’s exact test. Survival analysis used the Kaplan-Meier method. Events included: death, relapse, secondary malignancy, need for radiation therapy, pulmonary toxicity and cardiomyopathy determined by shortening fraction <29%. Analyses followed an intention-to-treat principle. Results: There was no difference in baseline characteristics between the patients receiving ABVE-PC or ABVD in regard for stage, risk group or prognostic variables, such as the presence or absence of “B” symptoms, bulky disease, and extra-nodal involvement. A greater proportion of patients treated with ABVE-PC received consolidating external beam radiation treatment (XRT) either by randomization or by response compared to ABVD (59.6% vs 32.6% respectively, p=0.01). While not statistically significant, response to therapy, assessed by PET/CT where available, mirrored the need for radiation (rapid response 58.3% vs 90.0%, n=34, p=0.11). There was no difference in event-free survival (p=0.63) or overall survival (p=0.37) with a median follow up length of 3.9 years. Conclusion: ABVD and ABVE-PC achieved similar survival outcomes in our single-institution cohort
09 Sep 2021Submitted to Pediatric Blood & Cancer
09 Sep 2021Submission Checks Completed
09 Sep 2021Assigned to Editor
11 Sep 2021Reviewer(s) Assigned
26 Sep 2021Review(s) Completed, Editorial Evaluation Pending
27 Sep 2021Editorial Decision: Revise Major
05 Nov 20211st Revision Received
05 Nov 2021Submission Checks Completed
05 Nov 2021Assigned to Editor
11 Nov 2021Reviewer(s) Assigned
29 Nov 2021Review(s) Completed, Editorial Evaluation Pending
29 Nov 2021Editorial Decision: Revise Minor
17 Dec 2021Submission Checks Completed
17 Dec 2021Assigned to Editor
17 Dec 20212nd Revision Received
20 Dec 2021Reviewer(s) Assigned
04 Jan 2022Review(s) Completed, Editorial Evaluation Pending
10 Jan 2022Editorial Decision: Revise Minor
18 Jan 2022Submission Checks Completed
18 Jan 2022Assigned to Editor
18 Jan 20223rd Revision Received
28 Jan 2022Review(s) Completed, Editorial Evaluation Pending
28 Jan 2022Editorial Decision: Accept
May 2022Published in Pediatric Blood & Cancer volume 69 issue 5. 10.1002/pbc.29601